Throwing program after surgery

His arm hurts a LOT — is that normal? Is it torn again? How long should I wait to throw? The experience is similar for players but also completely and painfully unique.

Which of these is worse? Soreness often turns to pain. Tightness turns to any of them and makes throwing very uncomfortable. Deadness is demoralizing.

He basically just reminded me that my arm had holes drilled in it, and that the muscles and ligaments were sliced open before being stitched back together. I just had to learn to accept some of that. When I thought of it that way, I stopped dwelling on slight pain and the little aches and soreness — those were just from my arm being, well, a lot like an old car.

Old cars make lots of weird sounds and are a little bumpier, but they still drive just fine. Pitchers who have had a surgery — any surgery — are never going to feel fresh off the assembly-line again.

When they stop believing they have to feel perfect and brand new to pitch, things mentally get a lot better. Sure, when a player overdoes it or does something new, the arm usually reacts in a negative — but still normal — way.

This — unfortunately — is also normal. The follow exchange was had between myself and one of my college pitcher clients, who I have been mentoring through the last stages of his rehab in conjunction with his school coaches. It sums this point up perfectly. Most pitchers will feel like their old selves again somewhere between the 14 month and month mark. I doggy-paddled through my first season back following each surgery, struggling to keep my head above water and not get released by the team.

I posted league-average ERAs in both seasons and could not locate my off-speed stuff to save my life. I got by with good velocity and a fierce will to compete. Had I not had both of those things, my career would have ended; I would not have had enough tools to get by in pro baseball. But in year two following both surgeries, my command of all three pitches improved dramatically, and my velocity went up another tick or two.

Year two was much, much better than year one. Year one was hard. The uncertainty, randomness, pain and daily grind will challenge even the toughest of athletes. This should be standard reading that each athlete receives from his Dr. For example, a native healthy, strong UCL can withstand over pitches. The figure-of-eight graft gives out after only cycles. And the docking procedure fails after cycles. Using tables, drawings, and photos, the authors show each exercise and outline number of repetitions, range-of-motion, and how to advance to the next level.

The therapist must know which type of surgery was done in order to guide the patient through the safest and most effective rehab program. The main differences between the postop programs following a figure-of-eight versus modified Jobe procedure is in the timing of the motion allowed.

Rehab can be a bit more aggressive after the modified Jobe reconstruction. After either procedure, a posterior splint is used at first to hold the elbow in degrees of flexion. The patient is allowed to move the wrist and fingers but not the elbow.

The authors provide the rationale, precautions, and criteria for advancing the program from one step to the next, and from one phase to the next. Acute injuries heal faster and progress more rapidly through the rehab protocol than chronic injuries. In all cases, the goals are to promote healing, reduce pain, limit inflammation, and return to normal motion, strength, and function. Therapists will find this article helpful in describing what to do if the patient does not respond as expected.

Not getting full elbow extension using range-of-motion and mobilization techniques? Use a low-load, long-lasting stretch. However for the overhand athlete it is much more difficult to get back in the game with therapy. If they have failed in conservative care then arthroscopic suturing or repair of the labrum is the treatment of choice.

As mentioned above the majority will be able to return to their sport after surgery, but not as many as we would like, and perhaps not at the same level as before. So the question remains, to Throw or not to Throw? Overhand athletes who have undergone surgery but have not made it back to the level that they desire hit a crossroads. Some will take the risk and push on with the sport, but many will step down from competition and save their shoulder to live and enjoy another day.

Some are compelled to continue on through the pain to maintain or gain a scholarship. Little League Baseball along with American Sports Medicine Institute have provided our young throwers with a template for some level of restraint and common sense with its guidelines that not only limit pitch counts, but also recommend total rest from the overhand sport for 3 months out of every year.

These are the types of common sense steps that we can take for prevention in our current environment of hyper —competitive youth sports. Often you can make it back without invasive procedures, and you can learn strategies to keep it that way for life. English Polish Spanish. Boot camp for your meniscus.